Relapsing polychondritis

Abstract

Relapsing polychondritis is an uncommon disease consisting of inflammation of the eyes, inner ears, cardiovascular system, and cartilaginous portions of the joints, respiratory tract, and external ear. Cutaneous manifestations are the presenting feature in more than 50% of patients. These usually consist of erythema, swelling, and pain, reflecting involvement of the underlying cartilage. Direct involvement of the skin may occur as vasculitis, lesions resembling erythema nodosum, or nonspecific eruptions. The presence of circulating antibodies to type II collagen--more against native than denatured collagen--and to human fetal cartilage, and the presence of circulating immune complexes suggest a primary role for antibody in the pathogenesis of relapsing polychondritis. There is no ideal treatment, but systemic corticosteroids and dapsone seem most effective.